A new strategy for screening infectious diseases amongst migrants: the STRADA study

Background In France, the prevalence of HIV, HBV and HCV is high amongst migrants and widespread testing is recommended. All legal migrants in France undergo a mandatory medical check-up at the immigration center (OFII). This check-up is an opportunity to offer rapid HIV and hepatitis testing. A screening questionnaire for risk factors (TROD screen) has been developed and could help target the screening offer. The objective of the STRADA study is to evaluate the efficacy of a screening strategy for infectious diseases (Tuberculosis, HIV, HBV and HCV) based on risk-factor questionnaires amongst migrants during the medical check-up. Methods STRADA is a prospective, multicenter, observational study with two parts: tuberculosis screening (evaluation of a screening questionnaire) and HIV, HBV and HCV screening. For that part we have created a risk-based questionnaire for those three infections. In the first phase of the study, all migrants eligible are offered a screening, the TROD screen questionnaire. In the second phase, the screening offered on the basis of country of origin will be compared to the screening offered on the basis of the risk factor questionnaire. Finally, a cost-effectiveness study will be performed. During the informed consent process, participants are informed that the study is voluntary and independent from the residence permit. Preliminary results A risk-based questionnaire has been created and translated in 10 languages. The screening has been implemented in 20 immigration centers in France. In April 2019, 35,000 participants have answered the TB screen and 8,250 have been screened for at least one of the three virus. Discussion This study will determine the acceptability, performance, utility, costs and impact of a targeted optimized screening strategy for migrants in France. The presence of infectious diseases amongst migrants is a major public health issue. STRADA is an innovative initiative that has the potential to improve screening.